Prevalence of Fatigue in Head and Neck Cancer Survivors

Paolo Bossi, Patricia Di Pede, Mauro Guglielmo, Roberta Granata, Salvatore Alfieri, Nicola Alessandro Iacovelli, Ester Orlandi, Marco Guzzo, Roberto Bianchi, Letizia Ferella, Gabriele Infante, Rosalba Miceli, Lisa Licitra, Carla Ida Ripamonti

Research output: Contribution to journalArticlepeer-review


Introduction: In head and neck cancer (HNC) patients, fatigue is present throughout the course of treatment and during follow-up. There are limited data about the prevalence and factors associated with fatigue in HNC survivors. The objectives of this study were to assess the prevalence of fatigue and its interference with daily life activities and examine the association between fatigue and gender, age, primary tumour site, Human Papillomavirus (HPV) status, previous oncologic therapy, and time since end of treatment. Methods: Consecutive locally advanced HNC patients having completed curative treatment at least 1 year earlier and free of disease were asked to fill in the Brief Fatigue Inventory (BFI) questionnaire. Fatigue was categorized according to BFI average score as absent (0), mild (>0 to <4), moderate (≥4 to ≤6), and severe (>6 to ≤10). Results: From February 2015 to July 2016, 129 patients (median age = 60 years old; 67% male) were evaluated. Primary sites of cancer were oropharynx (46%, with 4/5 patients HPV positive), nasopharynx (22%), larynx/hypopharynx (14%), oral cavity (13%), and paranasal sinus or salivary gland (5%). Oncologic treatment was completed 12 to 96 months earlier (median = 34 months). Fatigue was reported as absent in 15% of the patients, mild in 67%, moderate in 11%, and severe in 7%. No association between BFI average score and the analyzed variables was identified. Discussion: Moderate and severe fatigue was reported in 18% of HNC survivors. Further research is needed to assess its causes and improve the management.

Original languageEnglish
Pages (from-to)413-419
Number of pages7
JournalAnnals of Otology, Rhinology and Laryngology
Issue number5
Publication statusPublished - May 1 2019


  • fatigue
  • head and neck neoplasms
  • patient reported outcome measures
  • quality of life
  • survivals

ASJC Scopus subject areas

  • Otorhinolaryngology


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